EP2626063B1 - Diclofenac gel - Google Patents

Diclofenac gel Download PDF

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Publication number
EP2626063B1
EP2626063B1 EP13166999.6A EP13166999A EP2626063B1 EP 2626063 B1 EP2626063 B1 EP 2626063B1 EP 13166999 A EP13166999 A EP 13166999A EP 2626063 B1 EP2626063 B1 EP 2626063B1
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gel
formulation
present
diclofenac sodium
gel formulation
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German (de)
English (en)
French (fr)
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EP2626063A1 (en
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Ed Kisak
Jagat Singh
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Nuvo Pharmaceuticals Inc
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Nuvo Pharmaceuticals Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
    • A61K47/36—Polysaccharides; Derivatives thereof, e.g. gums, starch, alginate, dextrin, hyaluronic acid, chitosan, inulin, agar or pectin
    • A61K47/38—Cellulose; Derivatives thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19—Carboxylic acids, e.g. valproic acid
    • A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
    • A61K31/196—Carboxylic acids, e.g. valproic acid having an amino group the amino group being directly attached to a ring, e.g. anthranilic acid, mefenamic acid, diclofenac, chlorambucil
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
    • A61K47/10—Alcohols; Phenols; Salts thereof, e.g. glycerol; Polyethylene glycols [PEG]; Poloxamers; PEG/POE alkyl ethers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/16—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing nitrogen, e.g. nitro-, nitroso-, azo-compounds, nitriles, cyanates
    • A61K47/18—Amines; Amides; Ureas; Quaternary ammonium compounds; Amino acids; Oligopeptides having up to five amino acids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/16—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing nitrogen, e.g. nitro-, nitroso-, azo-compounds, nitriles, cyanates
    • A61K47/18—Amines; Amides; Ureas; Quaternary ammonium compounds; Amino acids; Oligopeptides having up to five amino acids
    • A61K47/183—Amino acids, e.g. glycine, EDTA or aspartame
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/20—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing sulfur, e.g. dimethyl sulfoxide [DMSO], docusate, sodium lauryl sulfate or aminosulfonic acids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
    • A61K47/32—Macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds, e.g. carbomers, poly(meth)acrylates, or polyvinyl pyrrolidone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
    • A61K47/34—Macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyesters, polyamino acids, polysiloxanes, polyphosphazines, copolymers of polyalkylene glycol or poloxamers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0014—Skin, i.e. galenical aspects of topical compositions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/06—Ointments; Bases therefor; Other semi-solid forms, e.g. creams, sticks, gels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00—Drugs for skeletal disorders
    • A61P19/02—Drugs for skeletal disorders for joint disorders, e.g. arthritis, arthrosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]

Definitions

  • the present invention relates generally to compositions for treating osteoarthritis.
  • Osteoarthritis is a chronic joint disease characterized by progressive degeneration of articular cartilage. Symptoms include joint pain and impaired movement. OA is one of the leading causes of disability worldwide and a major financial burden to health care systems. It is estimated to affect over 15 million adults in the United States alone. See Boh L.E. Osteoarthritis. In: DiPiro J.T., Talbert R.L., Yee G.C., et al., editors. Pharmacotherapy: a pathophysiological approach. 4th ed. Norwalk (CT): Appleton & Lange, pp. 1441-59 (1999 ).
  • CT Norwalk
  • NSAIDs Oral non-steroidal anti-inflammatory drugs
  • NSAIDs are a mainstay in the management of OA. They have analgesic, anti-inflammatory and antipyretic effects and are useful in reducing pain and inflammation.
  • NSAIDS are however associated with serious potential side effects including nausea, vomiting, peptic ulcer disease, GI haemorrhage, and cardiovascular events.
  • Topical NSAIDs offer the possibility of achieving local therapeutic benefit while reducing or eliminating the risk of systemic side effects.
  • There has been widespread interest in this approach to treating OA but data in support of the efficacy of topical NSAIDs in the treatment of OA is limited.
  • RCT's placebo controlled trials
  • Efficacy of topical non-steroidal anti-inflammatory drugs in the treatment of osteoarthritis metaanalysis of randomized controlled trials, BMJ, doi: 10.1136/bmj.38159.639028.7C (2004 )).
  • U.S. Patent Nos. 4,575,515 and 4,652,557 disclose topical NSAID compositions, one of which, consisting of 1.5% diclofenac sodium, 45.5% dimethylsulphoxide, 11.79% ethanol, 11.2% propylene glycol, 11.2% glycerine, and water, has been shown to be effective in chronic OA treatment. See Towheed, Journal of Rheumatology 33:3 567-573 (2006 ) and also Oregon Evidence Based Practice Center entitled “Comparative Safety and Effectiveness of Analgesics for Osteoarthritis", AHRQ Pub. No. 06-EHC009-EF. This particular composition is referred to herein as "comparative liquid formulation” or "comparative" in the Examples section.
  • compositions of these prior inventions have drawbacks in that they are slow to dry and runny. They also require frequent dosing of three to four times a day to achieve efficacy in OA, which increases exposure to potential skin irritants and increases the risk of skin irritation.
  • topical NSAIDs In general, the failure of topical NSAIDs to fulfill their promise in OA may be due in part to the difficulty associated with delivering a molecule through the skin in sufficient quantities to exert a therapeutic effect and in a manner that makes the treatment itself tolerable. It is generally believed that clinical efficacy in OA requires absorption of the active ingredient and its penetration in sufficient quantities into underlying inflamed tissues including the synovium and synovial fluid of joints. See Rosenstein, Topical agents in the treatment of rheumatic disorders, Rheum. Dis. Clin North Am., 25: 899-918 (1999 ).
  • transdermal drug delivery in general remains fairly limited with only a small number of transdermal drug products commercially available.
  • Naito demonstrates significant variability in penetration among topical NSAID formulations simply by changing the gelling agent used in the compositions
  • Naito et al. Percutaneous absorption of diclofenac sodium ointment, Int. Jour. of Pharmaceutics, 24: 115-124 (1985 )
  • Ho noted significant variability in penetration by changing the proportions of alcohol, propylene glycol, and water
  • Ho et al. The influence of cosolvents on the in-vitro percutaneous penetration of diclofenac sodium from a gel system, J. Pharm. Pharmacol., 46:636-642 (1994 )
  • the changes affected three distinct variables: (i) the solubility of the drug in the vehicle, (ii) the partition coefficient, and (iii) effects on alteration of skin structure.
  • Chemical penetration enhancers are one means for reversibly lowering the skin barrier. Other methods include iontophoresis, ultrasound, electroporation, heat, and microneedles. At least 250 chemicals have been identified as enhancers that can increase skin permeability. General categories include pyrrolidones, fatty acids, esters and alcohols, sulfoxides, essential oils, terpenes, oxazoldines, surfactants, polyols, azone and derivatives, and epidermal enzymes.
  • compositions of the invention use diclofenac sodium which is a commonly used NSAID.
  • Diclofenac has four different salts that show significant variability in the degree of permeation in solutions using different solvents. Minghetti, for instance, teaches that a diclofenac salt with an organic base is best for topical applications ( Minghetti et al., Ex vivo study of trandermal permeation of four diclofenac salts from different vehicles, Jour. of Pharm. Sci, DOI 10.1002/jps.20770 (2007 )).
  • the present invention overcomes the disadvantages of the prior art by providing diclofenac sodium gel formulations for the treatment of osteoarthritis that display a better drying time, higher viscosity, increased transdermal flux, and greater pharmacokinetic absorption in vivo when compared to previously described compositions.
  • the preferred diclofenac sodium gel formulations of the present invention provide other advantages including favorable stability at six (6) months as reflected in the lack of any substantial changes in viscosity, the absence of phase separation and crystallization at low temperatures, and a low level of impurities.
  • the present gel formulations adhere well to the skin, spread easily, dry quicker, and show greater in vivo absorption in comparison to previously described compositions.
  • the gel formulations of the present invention provide superior means for delivery of diclofenac sodium through the skin for the treatment of osteoarthritis, as compared to previously described formulations.
  • the present invention provides a gel formulation comprising,
  • the present invention provides a gel formulation comprising:
  • a further embodiment provides a medicament comprising any of the gel formulations claimed herein.
  • the medicament may be for use in treating pain or for use in treating osteoarthritis in a subject suffering from articular pain.
  • the present invention provides a composition for use in the treatment of osteoarthritis in a subject suffering from articular pain, wherein said composition is any of the gel formulations claimed herein, and wherein said composition is formulated for gel administration of a therapeutically effective amount of the gel formulation to an afflicted joint area of said subject. Further provided is a composition comprising any of the gel formulations claimed herein for use in the treatment of pain.
  • the thickening agents can be selected from hydroxypropyl-cellulose polymers and carbomer polymers, as defined in the claims
  • diclofenac sodium is present in the gel formulations at 2% w/w; DMSO is present at 45.5% w/w; ethanol is present at 23-29% w/w; propylene glycol is present at 10-12% w/w; hydroxypropylcellulose (HY119) is present at 0-6% w/w; glycerol is present at 0-4%, and water is added to make 100% w/w.
  • HY119 hydroxypropylcellulose
  • glycerol is present at 0-4%, and water is added to make 100% w/w.
  • the end viscosity of the gel is 500-5000 centipoise (0.5-5 Pa ⁇ s).
  • a feature of the above gel formulations is that when such formulations are applied to the skin, the drying rate is quicker and transdermal flux is higher than previously described compositions, such as those in U.S. Patent Nos. 4,575,515 and 4,652,557 .
  • Additional features of the preferred formulations include decreased degradation of diclofenac sodium, which degrades by less than 0.04% over the course of 6 months and a pH of 6.0-10.0, for example around pH 9.0.
  • the gel formulations of the invention comprise 1-5% glycerol, wherein the gel formulation when applied to the skin has a drying rate and transdermal flux greater than a comparative liquid formulation.
  • the drying rate results in a residue of at most 50% of a starting amount after 24 hours and the transdermal flux is 1.5 or more greater than a comparative liquid formulation as determined by Franz cell procedure at finite or infinite dosing or both.
  • the composition is applied twice daily.
  • transdermal is used herein to generally include a process that occurs through the skin.
  • transdermal and percutaneous are used interchangeably throughout this specification.
  • Topical formulation is used herein to generally include a formulation that can be applied to skin or a mucosa. Topical formulations may, for example, be used to confer therapeutic benefit to a patient or cosmetic benefits to a consumer. Topical formulations can be used for both topical and transdermal administration of substances.
  • topical administration is used herein to generally include the delivery of a substance, such as a therapeutically active agent, to the skin or a localized region of the body.
  • Transdermal administration is used herein to generally include administration through the skin. Transdermal administration is often applied where systemic delivery of an active agent is desired, although it may also be useful for delivering an active agent to tissues underlying the skin with minimal systemic absorption.
  • penetration enhancer is used herein to generally include an agent that improves the transport of molecules such as an active agent (e.g., a medicine) into or through the skin.
  • an active agent e.g., a medicine
  • Various conditions may occur at different sites in the body either in the skin or below the skin creating a need to target delivery of compounds.
  • a “penetration enhancer” may be used to assist in the delivery of an active agent directly to the skin or underlying tissue or indirectly to the site of the disease through systemic distribution.
  • a penetration enhancer may be a pure substance or may comprise a mixture of different chemical entities.
  • the term "finite dosing" is used herein to generally include an application of a limited reservoir of an active agent.
  • the reservoir of the active agent is depleted with time leading to a tapering off of the active absorption rate after a maximum absorption rate is reached.
  • infinite dosing is used herein to generally include an application of a large reservoir of an active agent.
  • the reservoir is not significantly depleted with time, thereby providing a long term, continuous steady state of active absorption.
  • the term "comparative liquid formation” or “comparative” refers to a formulation such as that described in U.S. Patent Nos. 4,575,515 and 4,652,557 consisting of 1.5% diclofenac sodium, 45.5% dimethylsulfoxide, 11.79% ethanol, 11.2% propylene glycol, 11.2% glycerine, and water.
  • the present invention provides gel formulations as claimed comprising the sodium salt of diclofenac Diclofenac sodium may be present in a range of 1% to 5%, such as 1, 2, 3, 4, or 5% w/w.
  • Use of the sodium salt has been known to create a challenge with respect to stability of an aqueous gel in that higher salt concentrations can cause a breakdown in the gel matrix through interaction with certain thickening agents.
  • the gel formulation includes a penetration enhancer, dimethyl sulfoxide (“DMSO”), in an amount by weight of 30% to 60%, such as 30, 40, 45, 50, 55, or 60% w/w.
  • DMSO dimethyl sulfoxide
  • DMSO is used in the present invention at a concentration of about 40 to about 50% w/w, such as 41, 42, 43, 44, 45, 46, 47, 48, 49 and 50% and all fractions in between such as 44, 44.5, 45, 45.5, 46, 46.5%, and the like.
  • the gel formulation includes ethanol, present at 1 to 50% w/w, such as 1, 5, 10, 15, 20, 25, 30, 35, 40, 45, or 50% w/w, and all fractions in between.
  • the gel formulation the present invention includes propylene glycol present at 1-15% w/w, such as 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, or 15% w/w, and all fractions in between.
  • the present invention includes glycerol (also referred to herein as glycerine) at a concentration of 1-12% w/w.
  • glycerol is used at 1-4% w/w, such as 1, 2, 3, or 4 % w/w, and all fractions in between.
  • the thickening agent is hydroxypropylcellulose
  • no glycerol is used in the formulation. wherein the thickening agent is
  • the present invention provides a formulation comprising a diclofenac solution and at least one thickening agent to make a gel.
  • the at least one thickening agent of the present invention may be a Carbopol polymer or a hydroxypropyl-cellulose polymer, as presently claimed.
  • the at least one thickening agent is hydroxypropylcellulose (HPC) used such that the end viscosity is between 10 and 50000 centipoise (cps) (0.01 - 50 Pa ⁇ s). More preferably the end viscosity is between 500 and 20000 cps (0.5 - 20 Pa ⁇ s).
  • the present gel formulation may optionally include at least one antioxidant and/or one chelating agent.
  • Preferred antioxidants for use in the present invention may be selected from the group consisting of butylated hydroxytoluene (BHT), butylated hydroxyanisole (BHA), ascorbyl linoleate, ascorbyl dipalmitate, ascorbyl tocopherol maleate, calcium ascorbate, carotenoids, kojic acid, thioglycolic acid, tocopherol, tocopherol acetate, tocophereth-5, tocophereth-12, tocophereth-18, tocophereth-80, and mixtures thereof.
  • BHT butylated hydroxytoluene
  • BHA butylated hydroxyanisole
  • ascorbyl linoleate ascorbyl dipalmitate
  • ascorbyl tocopherol maleate calcium ascorbate
  • carotenoids kojic acid
  • thioglycolic acid tocopherol
  • tocopherol acetate tocophereth-5
  • Preferred chelating agents may be selected from the group consisting of ethylenediamine tetraacetic acid (EDTA), diammonium EDTA, dipotassium EDTA, calcium disodium EDTA, HEDTA, TEA-EDTA, tetrasodium EDTA, tripotassium EDTA, trisodium phosphate, diammonium citrate, galactaric acid, galacturonic acid, gluconic acid, glucuronic acid, humic acid, cyclodextrin, potassium citrate, potassium EDTMP, sodium citrate, sodium EDTMP, and mixtures thereof.
  • EDTA ethylenediamine tetraacetic acid
  • diammonium EDTA dipotassium EDTA
  • calcium disodium EDTA HEDTA
  • TEA-EDTA tetrasodium EDTA
  • tripotassium EDTA trisodium phosphate
  • diammonium citrate galacta
  • the topical formulations of the present invention can also comprise a pH adjusting agent.
  • the pH adjusting agent is a base. Suitable pH adjusting bases include bicarbonates, carbonates, and hydroxides such as alkali or alkaline earth metal hydroxide as well as transition metal hydroxides.
  • the pH adjusting agent can also be an acid, an acid salt, or mixtures thereof.
  • the pH adjusting agent can also be a buffer.
  • Suitable buffers include citrate/citric acid buffers, acetate/acetic acid buffers, phosphate/phosphoric acid buffers, formate/formic acid buffers, propionate/propionic acid buffers, lactate/lactic acid buffers, carbonate/carbonic acid buffers, ammonium/ammonia buffers, and the like.
  • the pH adjusting agent is present in an amount sufficient to adjust the pH of the gel formulation to between about pH 6.0 to about 10.0, more preferably about pH 7.0 to about 9.5.
  • the unadjusted pH of the admixed components is between 8 and 10, such as 9, without the need for the addition of any pH adjusting agents.
  • the present invention provides diclofenac sodium gel formulations that display surprisingly effective rates of transdermal flux when compared to previously described formulations.
  • the present gel formulation comprises a diclofenac solution and at least one thickening agent as claimed and has a flux as determined by the finite Franz cell procedure at least equivalent to the flux of the diclofenac solution alone.
  • the diclofenac sodium gel formulation has a flux that is at least 2.0 times greater compared to the flux of the diclofenac sodium solution alone.
  • the present invention provides a diclofenac sodium gel formulation having a flux that is at least 4.0 times greater compared to the flux of the diclofenac sodium solution alone.
  • the ratio of: (i) the flux of the diclofenac sodium gel formulation to (ii) the flux of the diclofenac sodium solution is at least about 1.0, preferably at least about 2.0, more preferably at least about 4.0.
  • the present invention provides a diclofenac sodium gel formulation comprising diclofenac sodium and at least one thickening agent as claimed and having a flux as determined by the multiple finite dosing Franz cell procedure (dosing at 2.5mg/cm 2 at 0 and 6 hours) of at least 0.1 ⁇ g/hr/cm 2 at 24 hours, preferably at least 0.2 ⁇ g/hr/cm 2 at 24 hours.
  • the present invention provides a gel formulation comprising diclofenac sodium and at least one thickening agent as claimed, the gel formulation having a viscosity of at least 10cP (0.01 Pa ⁇ s).
  • the gel formulation has a viscosity of at least 500 cP (0.5 Pa ⁇ s). More preferably, the gel formulation has a viscosity of at least 1000 cP (1 Pa ⁇ s). Inother embodiments, the viscosity is 5000-10,000, 10,000-15,000, or 15,000-20,000 cP (5-10, 10-15, or 15-20 Pa ⁇ s).
  • the present invention provides a diclofenac gel formulation comprising a diclofenac solution and at least one thickening agent as claimed, the gel formulation having a viscosity of around 1000 cP (1 Pa ⁇ s) and a flux of at least 0.2 ⁇ g/cm 2 /hr as determined by the multiple finite dose Franz cell procedure (2.5 mg/cm 2 at 0 and 6 hours) at 24 hours.
  • the stability of a drug product composition can have a significant impact on the length and cost of drug development, the nature of the studies required to support regulatory submissions, and the ultimate safety and approvability.
  • compositions that are designed to increase skin permeability.
  • the present invention provides a diclofenac sodium gel formulation that degrades by less than 1% over the course of 6 months at room temperature. More preferably, the rate of degradation is less than 0.9, 0.8, 0.7, 0.6, 0.5, 0.4, 0.3, 0.2, or less than 0.1 %, and all fractions in between, over the course of 6 months at room temperature.
  • compositions of the invention dry quicker while achieving higher transdermal flux of the drug. It is surprising that higher flux rate and quicker drying can be achieved together as skin hydration is known to increase transdermal flux or penetration. The drying of the skin caused by rapid evaporation would tend to reduce the transdermal transport of drug remaining on the skin. The drying time difference is evident when equal amounts of the two products are tested on opposite limbs. Within thirty (30) minutes the compositions of the invention are almost completely dry whereas a significant amount of the previously described liquid formulation remains.
  • the present invention discloses a method for making gel formulations of diclofenac sodium.
  • the gel formulations of the present invention are preferably made by carrying out the following steps: (i) dispersing the thickener in dimethyl sulfoxide and stirring for 1 hour; (ii) dissolving diclofenac sodium in an aqueous alcohol mixture (e.g., an ethanol/water mixture); (iii) dispersing propylene glycol and glycerol into the NSAID solution from (ii); and (iv) mixing the resulting NSAID solution into the thickener/dimethyl sulfoxide blend and stirring for 1 hour at ambient temperature.
  • an aqueous alcohol mixture e.g., an ethanol/water mixture
  • dispersing propylene glycol and glycerol into the NSAID solution from (ii)
  • mixing the resulting NSAID solution into the thickener/dimethyl sulfoxide blend and stirring for 1 hour at ambient temperature.
  • the gel formulations of the present invention may be made by carrying out the following steps: (i) dissolving the diclofenac sodium in an alcohol solution of DMSO (e.g., an ethanol/dimethyl sulfoxide mixture); (ii) dispersing the thickener in a solution of water/propylene glycol/glycerol and stirring for 1 hour; (iii) mixing the NSAID solution from (i) into the thickener blend from (ii) and stirring for 1 hour at ambient temperature. Heating can also be used during these mixing processes to help facilitate the gel formation. 5
  • DMSO e.g., an ethanol/dimethyl sulfoxide mixture
  • dispersing the thickener in a solution of water/propylene glycol/glycerol and stirring for 1 hour
  • mixing the NSAID solution from (i) into the thickener blend from (ii) and stirring for 1 hour at ambient temperature Heating can also be used during these mixing processes to help facilitate the gel formation. 5
  • Diclofenac sodium may be present in a range of 1% to 5% w/w, such as 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, and 5.0% w/w.
  • Compositions of the invention are particularly suited for use in treating osteoarthritis (OA) chronically. They may also be useful for the treatment of other chronic joint diseases characterized by joint pain, degeneration of articular cartilage, impaired movement, and stiffness. Suitable joints include the knee, elbow, hand, wrist and hip.
  • the formulations of the present invention can be administered at lower dosing than previously described formulations.
  • the compositions of the invention can be used at twice a day dosing or once a day dosing in the treatment of OA. This would represent a significant improvement as lower dosing is associated with better patient compliance, an important factor in treating chronic conditions.
  • Suitable amounts per administration will generally depend on the size of the joint, which varies per individual and per joint, however a suitable amount may range from 0.5 ⁇ l/cm 2 to 4.0 ⁇ l/cm 2 . Preferably the amount ranges from 2.0 to 3.0 ⁇ /cm 2 .
  • compositions of the present invention may, if desired, be presented in a bottle or jar or other container approved by the FDA, which may contain one or more unit dosage forms containing the active ingredient.
  • the pack or dispenser may also be accompanied by a notice associated with the container in a form prescribed by a governmental agency regulating the manufacture, use or sale of pharmaceuticals, which notice indicates approval by the agency of the form of the compositions for human or veterinary administration.
  • Such notice for example, may be of labeling approved by the U.S. Food and Drug Administration for prescription drugs, or of an approved product insert.
  • Compositions comprising a preparation of the invention formulated in a compatible pharmaceutical carrier may also be prepared, placed in an appropriate container, and labeled for treatment of an indicated condition.
  • Table 1 provides a list of the materials used in the examples provided below: Table 1: Materials Abbr Chemical FW Source Vendor # CAS BHA Butylated hydroxyanisole 180.24 Sigma B1253 25013-16-5 BHT Butylated hydroxytoluene 220.36 Spectrum BH110-07 128-37-0 Carb940 Carbopol 940 Noveon Carbopol 940 9003-01-4 Carb971 Carbopol 971 Noveon Carbopol 971 9003-01-4 Carb974 Carbopol 974 Noveon Carbopol 974 9003-01-4 Carb981 Carbopol 981 Noveon Carbopol 981 9003-01-4 Carb1342 Carbopol 1342 Noveon Carbopol 1342 9003-01-4 Diclo Diclofenac Sodium 318.1 Labochim 15307-79-6 DMSO Dimethyl Sulfoxide (USP) 78.1 Gaylord EM-2951 67-68-5 EDTA Disodium Ethy
  • Final weight for each formulation was 25 g prepared in 50-mL glass vials. Vortexing or magnetic stir bars were used to mix the gels.
  • Viscosity was measured at 22°C using Brookfield DV-III Ultra, programmable Rheometer with LV Spindle #31 at 10 rpm.
  • gels were stored at ambient temperature or in an incubator at 50°C. Discoloration or changes in appearance including phase separation over time were evaluated.
  • the concentration of the DMSO was consistent in all of the experiments (45.5% w/w).
  • Propylene glycol was at either 11 or 11.2% w/w.
  • Ethanol concentration varied from 11% to 30% w/w.
  • Glycerol concentrations were varied from 0 to 11.2% w/w.
  • the diclofenac sodium concentration was at either 1.5% (w/w) or 2% (w/w). Water was adjusted to compensate for the amount of inactives, thickening agents, and diclofenac sodium present in solution.
  • Franz diffusion cell experiments were used to analyze diclofenac sodium flux rates of varying gel formulations across a substrate membrane.
  • Franz diffusion cells are a common and well known method for measuring transdermal flux rates. The general Franz cell procedure is described in Franz, T.J., Percutaneous absorption: on the relevance of in vitro data. J Invest Derm, 64:190-195 (1975 ). The following was the methodology used in the present Examples.
  • Dosing levels varied from 2 mg/cm 2 (considered finite dose) to 200 mg/cm 2 (considered infinite dose).
  • the donor well was then capped to prevent evaporation.
  • Receptor wells of the Franz cells were maintained at 37°C (temperature on the surface of the skin is ⁇ 31°C) in a stirring dry block with continual agitation via a stir bar. Samples were drawn from the receptor wells at varying time points. Measurements were made in six-fold replicates. The concentration of diclofenac in the samples was analyzed using high performance liquid chromatography.
  • the inventive formulations performed better than the comparator at the limits of finite dosing - finite dosing being a much better predictor of the performance of a formulation in an in vivo situation as opposed to infinite dosing.
  • Example 2 Gel formulations using various thickeners in a comparative liquid formulation base solution
  • thickeners including carbomers, polyvinyl pyrrolidone, locust gum, cellulose polymers and polyvinyl alcohol were tested for their effectiveness at forming a diclofenac sodium gel using the comparative liquid formulation as a base solution.
  • a comparative liquid formulation solution was produced and a thickener was then added directly to this base.
  • sonication and heating at 60°C, along with vigorous vortexing/homogenization were performed.
  • thickeners specifically guar gum, locust bean gum, methocel (HPMC), polyvinyl alcohol, and poloxamer 407 failed to form stable gels. In particular, immediate separation, inefficient thickening, and insolubility of the thickeners was noted. Gels were formed that showed initial stability with several cellulose polymers including hydroxyethyl cellulose (Natrosol HHX) and hydroxypropylcellulose (HY119). Other thickeners that showed an initially stable gel were PVP, and acrylic polymer thickeners.
  • HEC thickening agents A lower weight molecular weight hydroxyethyl cellulose (specifically Hydroxyethyl Cellulose (HEC) Type 250 M Pharm (Natrosol ® )) was dispersed in the mixture of dimethyl sulfoxide, propylene glycol, glycerine and water and allowed to swell for about 1 hour. Diclofenac sodium was dissolved in ethanol and added to the HEC/solvent blend to obtain a final formulation. Although HEC gels form relatively easily and demonstrate a good flux profile, the gels are yellowish in color and are susceptible to phase separation over extended periods of storage. Table 2 shows the compositions of these formulations, and the resulting flux values of these compositions as compared with a comparative liquid formulation are shown in Figure 1 .
  • HEC Hydroxyethyl Cellulose
  • PVP thickening agents PVP was added at up to 8% w/v after all other components of the comparative liquid base formulation were mixed. PVP gels are clear in nature, but suffer from an undesirable tacky feel when drying. Table 2 and Figure 1 shows the composition and flux data for this gel. In this example, Franz diffusion cells were dosed at 15 mg per Franz cell. As can be seen in Figure 1 , PVP gels performed reasonably well, but their undesirable aesthetic qualities do not make them ideal for a commercial embodiment. Table 2: Components of HEC and PVP gels used to generate the flux rate data shown in Figure 1.
  • Carbopol thickening agents were formed by: (1) dispersing an acrylic polymer into a mixture of water, glycerol, and propylene glycol followed by stirring for 1 hour; (2) preparing a second solution of 1.5% diclofenac sodium dissolved in ethanol and DMSO; (3) mixing the diclofenac solution into the carbopol phase.
  • An alternate method for forming carbopol gels is as follows: (1) dispersing the carbopol into dimethyl sulfoxide and stirring for 1 hour; (2) dissolving diclofenac sodium in an ethanol/water/propylene glycol mixture; (3) dispersing glycerol into the diclofenac solution; and (4) mixing the diclofenac solution into the polymer/dimethyl sulfoxide blend, and stirring for 1 hour at ambient temperature. These methods of mixing can be carried out at room temperature, or elevated temperature if desired. Varying carbopols were used to make gels including: Carbopol 1342, 941, 971, 981, 974 and Ultrez 10 (Noveon, Inc.).
  • Antioxidants and chelating agents can also be added to the carbopol, HEC, or PVP gels.
  • the addition of EDTA to carbopol gels by itself leads to a slightly cloudy gel. BHA gels turned color with incubation at higher temperature. The mixture of BHT and EDTA to carbopol gels did not show any discoloration and remained clear.
  • Franz diffusion cells were dosed at 50 ⁇ l per cell. Figure 3 shows flux rates from these gels. Additions of chelating agents and preservatives had no effect on flux rates.
  • Table 4 Components of gels made with carbopol 971 and carbopol 981 gels used to generate the flux rate data shown in Figure 3.
  • Formulation name PP51 PP52 PP53 Comparative 2% Percentages in wt/wt% wt/wt% wt/wt% wt/wt% wt/wt% Water qs qs qs 18.31 Dimethyl Sulfoxide 45.5 45.5 45.5 45.5 Propylene glycol 11.2 11.2 11.2 Ethanol 11.79 11.79 11.8 11.79 Glycerine 11.2 11.2 11.2 11.2 11.2 Diclofenac Sodium 2 2 2 2 BHT 0.1 0.1 EDTA 0.05 0.05 Thickener Carbopol 971 Carbopol 971 Carbopol 981 none wt/wt% thickener 1 1 0.9
  • Example 3 Comparison of transdermal flux of various DMSO gel formulations versus a comparative liquid formulation
  • 0098a A series of diclofenac gel formulations were made wherein the base solution was changed from the comparative base formulation. In particular, the weight percent of propylene glycol, ethanol, glycerine, water, and diclofenac were varied. In these new formulations, the weight percent of the constituent chemicals was as follows: 45.5 % DMSO, 20-30 % ethanol, 10-12 % propylene glycol, 0-4% glycerine, 2% diclofenac sodium, thickener and water added to 100% w/w.
  • Hydroxypropylcellulose gels were formed by mixing all the constituent parts and then adding the thickener at the end followed by agitation. The gel can also be formed by dispersing the hydroxypropylcellulose in the aqueous phase prior to solvent addition. Heat can be used to facilitate gel formation. Hydroxypropylcellulose gels were clear and flowed easily. They remain stable for at least six months demonstrating: no phase separation, negligible shift in pH, and low amounts of degradation products ( ⁇ 0.04%).
  • the data in Figures 4-9 derived from the formulations of Tables 5-10, indicate that the hydroxypropylcellulose gel formulations of diclofenac sodium of the present invention also provide a transdermal flux rate that is as much as 4-fold higher than a comparative liquid formulation.
  • the comparative liquid formulation (1.5% diclofenac sodium) was dosed at 20 mg per Franz cell.
  • Solaraze ® (a commercially available 3% diclofenac sodium gel) was dosed at 10 mg per Franz cell, and F14/2 was dosed at 15 mg per Franz diffusion cell. At this dosing, all cells were dosed with equivalent amounts of diclofenac sodium. F14/2 continued to show increased performance over other formulations (see Figure 7 ).
  • Table 8 Components of various diclofenac formulations used to generate the flux rate data shown in Figure 7.
  • the comparative liquid formulation was dosed at 0.9 mg per Franz cell at 0, 4, 8, and 12 hrs.
  • F14/2 was dosed at 1.5 mg per Franz cell at 0 and 6 hrs.
  • the accumulated dose from the gel was considerably higher in comparison to the comparative solution, providing a ⁇ 1.5 fold increase in flux (see Figure 8 ).
  • Table 9 Components of formulations used in the multidosing experiments of Figure 8.
  • Formulation name Comparative F14/2 gel 2.5% F14/2 gel pH 8.5 Percentages in wt/wt% wt/wt% wt/wt% Water 18.81 12.5 45.5 Dimethyl Sulfoxide 45.5 45.5 11 Propyelene glycol 11.2 11 26.5 Ethanol 11.79 26.5 12.5 Glycerine 11.2 Diclofenac Sodium concentrated HCL 1.5 2 2 ⁇ added to pH 8.5 Thickener none HY119 HY119 wt% thickener 2.5 4 ⁇ 2.5
  • the Baboota formulations are labeled FY1, FY2, and FY3, while a gel formulation using the vehicle of the present invention with diclofenac diethylamine as the active is labeled G14/2_m.
  • a comparative liquid formulation was also included in this study ("Comparative").
  • DMSO concentrations in the present formulations 45.5% w/w versus 10% w/w.
  • the Baboota formulation is also a gel
  • the vehicle of the present invention provides a significantly greater flux rate.
  • the gel of the present invention provides an accumulated dose of 26.8 ⁇ g/cm 2 versus 8.9 ⁇ g/cm 2 for Baboota's best performing gel.
  • the gel of the present invention has a nearly 3-fold greater rate of flux and accumulation of diclofenac than a similar gel, as described by Baboota. Note that these experiments were conducted at finite dosing which is more representative of clinical dosing of a non-occluded composition that is applied periodically but which is not meant to be in continuous contact with the skin.
  • the Baboota gels also contained a higher percentage of the active agent, 3.4% w/w as compared to 2% w/w for the compositions using the vehicle of the invention.
  • the formulation of the present invention is significantly more effective at the transdermal delivery of a diclofenac active agent, when compared with another gel formulation, that described by Baboota et al. Furthermore, as shown in Figure 7 , the formulation of the present invention also performed remarkably better when compared to a diclofenac gel, Solaraze ® , a product currently sold on the market.
  • the present invention provides a diclofenac sodium gel formulation that has unexpectedly superior properties (e.g., with respect to parameters such as transdermal flux rates, favorable composition consistency, and greater stability and self life) when compared to the previously disclosed diclofenac diethylamine gel formulation described by Baboota or the diclofenac sodium formulation embodied by the Solaraze ® gel.
  • Table 11 Components of diclofenac diethylamine gels used to generate the flux rate data shown in Figure 10. For the formulations of Table 11, Franz diffusion cells were finite dosed at 4 mg per cell.
  • Example 5 Comparison of drying time/residual weight of a comparative liquid formulation solution versus the corresponding gel
  • the present invention provides a formulation which has a drying time such that, at most, a 50% weight of the starting amount remains as a residue after 24 hours of drying time, preferably a 30-40% or less weight of the starting amount remains as a residue after 24 hours of drying time.
  • the improved drying time of the gel formulations of the present invention provides improved ease of use and is expected to lead to better patient compliance.
  • this invention provides a gel formulation with improved drying characteristics while also providing improved drug delivery, as evidenced by the advantageous transdermal flux data shown in the examples above.
  • Table 12 Drying times for gels and a comparative liquid formulation solution. Equal weights of each formulation were measured and spread on weigh dishes. The weight of each remaining formulation was then followed with time. The gels of this invention showed faster drying kinetics than the comparative liquid formulation, with F14/2 showing the fastest drying rate. These gels also had improved "spreadability" characteristics, which most likely contributed to this improvement in drying rates.
  • compositions of the present invention provide a comparison of the stability of the compositions of the present invention tested against reference formulations at room temperature over a six month period. It was unexpectedly found that while the compositions of the invention contain a higher concentration of active agent, they in fact resulted in a lower concentration of a degradation impurity as compared to the reference. It was also unexpectedly found that compositions using hydroxypropylcellulose (HPC) as the gelling agent had a significantly lower quantity of this impurity as compared to compositions made using carbomer gelling agents.
  • HPC hydroxypropylcellulose
  • a gel formulation of the present invention containing 3.5% HPC shows a higher degree of stability, as reflected in the appearance of a lower percentage of "impurity A" as compared to a comparable liquid formation.
  • the data shown in Table 13 also shows that the HPC gel formation is more stable than a comparable gel formation containing 0.9% Carbopol, as the HPC gel formation demonstrates an at least 4-fold reduction in the level of impurity A.
  • a gel formation of the present invention provides improved stability of the active agent as compared to the reference formulations as evidenced in a formulation which degrades by less than 0.034% or 0.09%, over 6 months, as was observed for the reference formulations. Furthermore, the amount of "impurity A" found in the gel formulation of the present invention after a 6 month storage period would result in an exposure level well below limits that would require additional nonclinical testing testing of the impurity.
  • Example 7 Comparison of in vivo epicutaneous absorption of liquid versus gel formulations
  • the doses used in this study were as follows: The comparative solution group received 3.85 mg diclofenac sodium per administration and animal 4 times daily; the gel Group received 8.08 mg diclofenac sodium per administration and animal 2 times daily; the administration area was 5 cm x 10 cm/ animal. These amounts represent the scaled human clinical doses.
  • AUC Area under the curve
  • Table 15 Dosing in pigs Diclofenac Sodium % (w/w) Area of application (cm 2 ) Dose of the product per application (mL) Diclofenac Sodium per dose (mg) Number of doses per day Diclofenac per day (mg) Gel 2.0 50 0.40 8.08 bid 16.2 Comparative Solution 1.5 50 0.24 3.85 qid 15.4
  • Table 16 PK profile at steady state on Day 7 treatment subject Tmax (h) Cmax (pg/ml) AUC 0-24 (pg ⁇ h/ml) Gel 13 12 15379 239818 14 10 8570 175862 15 5 6014 104122 16 5 4827 63842 17 15 434829 2689765 18 24 14484 231494 Mean 12 80684 584151 SD 7 173549 1033
  • Example 8 Clinical trials of diclofenac gel in the treatment of osteoarithritis
  • a clinical trial will be performed to evaluate the safety and efficacy of a gel formulation of the present invention in subjects with symptoms of primary osteoarthritis (OA) of the knee.
  • OA primary osteoarthritis
  • a 2-arm, double-blinded, placebo-controlled, randomized, 12-week Phase III clinical trial will be performed in 300 subjects randomized to receive either a diclofenac gel formulation, placebo gel (the gel carrier containing no diclofenac).
  • Subjects will apply 2 mL of study gel to their OA knee per application.
  • the primary variables for assessment of efficacy will be the WOMAC LK3.1 pain and physical function and Patient Overall Health Assessment. Secondary variables will be the WOMAC stiffness and Patient Global Assessment.
  • the primary efficacy analyses will be the comparison of the change from baseline to final assessment of the primary efficacy variables for subjects in the diclofenac sodium gel arm versus the placebo gel arm.
  • the efficacy of diclofenac gel on knee OA symptoms will be measured by the subjective response of subjects as determined by an efficacy variables questionnaire which includes the WOMAC LK3.1 OA Index (pain, physical function, and stiffness dimensions), a Patient Overall Health Assessment, and a Patient Global Assessment. ( See Bellamy, N., WOMAC Osteoarthritis Index User's Guide IV, Queensland, Australia (2003 )).
  • the WOMAC LK3.1, Patient Overall Health Assessment and Patient Global Assessment questionnaires will be based on the five-point Likert scale. Numerical values will be assigned to WOMAC LK3.1 scores, Patient Global Assessment scores and Patient Overall Health Assessment scores, as follows:
  • the WOMAC LK3.1 OA Index is a segregated, multidimensional, self-administered index with three independent dimensions: pain, stiffness and physical function and will be used as an efficacy variable in this study.
  • application of the gel formulations of the invention when applied topically will result in a reduction of pain or physical function on the WOMAC scale of at least 1 Likert scale unit over a 12 week period. Even more preferably, a reduction of 2, 3, or 4 Likert scale units will result. Most preferably, application of the gel formulations of the invention will result in complete relief of pain and complete or nearly complete restoration of physical function.

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US8252838B2 (en) 2012-08-28
US20160213784A1 (en) 2016-07-28
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US9220784B2 (en) 2015-12-29
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US20080300311A1 (en) 2008-12-04
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